مريض يأخذ مضاد ذهان، حرارته ٤٠٫٢، عضلاته متصلبة جداً، ضغطه متذبذب، وهو مشوش. إنزيم CK مرتفع. ما الأرجح؟

A man on an antipsychotic has a temperature of 40.2°C, severe muscle rigidity, labile blood pressure and confusion. CK is high. What is most likely?

1. Serotonin syndrome from drug interaction
2. Akathisia
3. Neuroleptic malignant syndrome
4. Tardive dyskinesia

Answer: C) Neuroleptic malignant syndrome. High fever, lead-pipe rigidity, autonomic instability and raised CK indicate NMS; stop the drug, cool, and give dantrolene or bromocriptine.